Head-shaking nystagmus in patients with unilateral peripheral vestibular lesions

• Published in: American journal of otolaryngology Vol. 8; no. 1; pp. 36 - 47
• Main Authors: Hain, T.C., Fetter, M., Zee, D.S.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 1987; Elsevier
• Subjects: Adaptation, Physiological; Biological and medical sciences; Computer Simulation; Cranial Nerve Neoplasms - complications; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Head; Humans; Labyrinth Diseases - physiopathology; Medical sciences; Models, Biological; Neuroma, Acoustic - complications; Nystagmus, Physiologic; Otorhinolaryngology. Stomatology; Reflex, Vestibulo-Ocular; Rotation; Semicircular Canals - physiopathology; Space life sciences; Time Factors; Vestibular Nerve - physiopathology; Vestibulocochlear Nerve Diseases - etiology; Vestibulocochlear Nerve Diseases - physiopathology; Human; Peripheral vestibular syndrome; Motion; ENT disease; Head; Nystagmus test
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/S0196-0709(87)80017-0

In certain patients with peripheral or central vestibular lesions, a transient nystagmus appears after shaking the head rapidly for 10 to 20 cycles. We recorded such a “head-shaking mystagmus” using the scleral eye coil in six subjects with unilateral peripheral vestibular lesions. Horizontal head shaking elicited horizontal nystagmus with slow phases that were initially directed toward the side of the lesion and upward. All subjects showed a prolonged, lower-amplitude reversal phase after the initial response following horizontal head shaking. The main features of these results can be explained by an analytic model that incorporates 1) a central velocity-storage mechanism that perseverates vestibular inputs, 2) Ewald's second law, and 3) adaptation of primary vestibular afferent activity.